Medicare expands coverage to include obesity medications under new Bridge program

Effective July 1, Medicare’s Bridge demonstration program will allow qualifying beneficiaries to obtain FDA-approved obesity drugs, such as those from Novo Nordisk and Eli Lilly, for a $50 monthly copayment. The program requires enrollment in a Part D prescription plan, a physician’s prescription, and prior-authorization approval from the Centers for Medicare & Medicaid Services (CMS).

A survey of more than 2,100 adults aged 65 and older conducted in March found that 82 % of respondents were unaware of the upcoming coverage, a finding echoed by health-care providers who say public outreach has been limited. CMS officials said the agency prioritized informing providers and pharmacies first, noting that beneficiaries tend to act when a benefit becomes available.

Physicians and policy experts warned that low public awareness could delay enrollment. Dr. Shauna Levy, medical director of the Tulane Bariatric and Weight Loss Center, said many patients may not learn about the program until after it launches. Health-policy professor Kenneth Thorpe highlighted that, because the program is administered directly by CMS rather than through Part D plans, private insurers are not involved in beneficiary education.

Novo Nordisk and Eli Lilly have promoted the program through social-media posts and their websites but have not run television ads. Jamey Millar, executive vice president of U.S. operations at Novo, likened the rollout to annual flu-vaccine campaigns, suggesting pharmacists could inform seniors during routine visits. Lilly’s president Ilya Yuffa indicated that broader marketing to consumers is planned after providers are prepared.

Experts also noted that the prior-authorization requirement may limit an immediate surge in demand, allowing CMS to address operational challenges before scaling up the program.